Causes of Acne

Hello again peeps!

It’s a Saturday and I am spending the night at home (with good reason!). I am scheduled for LASIK on my right eye this Monday so I am pretty much blind since I can't wear contact lenses two days before. My left eye has already been zapped so I can see clearly with that eye. It is so weird being able to see out of one eye and not the other! It's giving me a headache L

Anyway, I digress… …

To make my stay-at-home weekend more productive, I've decided it is a good time to get going with my second post on the different causes of acne.

This ain't no easy task because there are so many contradicting views on what exactly causes acne. Even doctors have differing opinions! I am going to list what I believe causes acne, from both my own personal experience and information from online resources.

According to general medical practice, acne is caused by the overproduction of sebum or oil by the skin’s sebaceous glands. When this excess oil combines with dead skin cells and accumulate bacteria, it leads to inflammation and pimples. The next obvious question is then, why does the skin behave this way? Most doctors will say it's genetics. This can be true for some people; those whose parents had acne are more likely to have acne themselves. But I don't think this is the only reason.

Why people get acne is a complicated question that cannot be solved with a standardized answer. I am going to list some common causes of acne and you can see which ones apply to you. It is possible that a combination of reasons result in your acne. I believe that our skin is a reflection of our internal health so if you have acne, you have to look internally.

Cause #1 : GENETICS

Yes, this does play a role as we share the same genes as our parents. Those whose parents have clear skin are more likely to also have clear skin, and vice versa. 

Cause #2 : HORMONES

Hormones play a big role in the behaviour of our skin. Androgens, which are male hormones, help to control sebum production. When there is hormonal imbalance, the excess androgens cause our skin to overproduce sebum leading to problems like acne. There are 2 main groups that have this type of acne.

Teenage acne happens during puberty when sudden changes in hormone levels occur. Those in this group are lucky as the acne tends to stay only for a few years until hormone levels stabilize. The bad news is however, that the acne tends to be severe and can cause significant scarring. Teenage acne occurs often in boys as their androgen and testosterone levels increase drastically during this period.

Adult hormonal acne is another story altogether. This type of acne is more prevalent in women and starts after puberty, such as in one’s mid twenties or later. Unfortunately for this group, the acne is usually persistent and can last for a very long time even though the severity varies. A very obvious symptom of adult acne is when the pimples occur mostly around the jawline, chin and mouth areas.

Ladies are prone to breakouts just before That Time of the Month. (For those that don’t get these, how I envy you!) Also, some hormonal disorders such as Polycystic Ovarian Syndrome (PCOS) can result in acne. Other stages in life when one might experience acne are during pregnancy or menopause.

Since hormonal imbalance is one cause of acne, anything that affects our hormones thus affects acne, such as sleep, stress, lifestyle and diet.

Cause #3 : DIET

What we put in our body reflects in our skin and overall complexion. According to the eastern school of thought, we get acne when there is an accumulation of toxins in our bloodstream. One simple way to flush our toxins is to drink plenty of water. Hence, a lack of water can cause pimples although this is unlikely to result in severe acne.

There are a growing number of people developing food allergies that can trigger acne. For example, a common culprit is cow’s milk. Most of us grow up being told that milk is good for us, it provides calcium for our bones and some milk brands even include additional vitamins. However, what most of us are unaware of is that cows producing the milk are often fed with hormone-laced foods or injected with hormones to maximize their milk production. Remember Cause #2? Well, the hormones in this milk can wreak havoc on our own body’s hormones and hence cause acne. There are countless comments online on acne disappearance once dairy intake is stopped.

Other allergens may include citrus fruits and nuts.  

Sweets, chocolates, carbohydrates and any other forms of sugar are also bad for our skin. The sugar increases blood sugar levels and our body reacts by forming a hormone called insulin, which lowers blood sugar levels back to more acceptable levels. High insulin levels increases another hormone called IGF-1. IGF-1 increases our sebum levels, enlarges pore size and thus results in acne. So higher levels of such hormones actually increases the severity of the pimples.

Another bad thing about sugar is that it reduces the amount of antioxidants on our skin and promotes inflammation. So if you have clogged pores that turn into pimples, these are likely to become pus-filled with more redness around them. Since it depletes antioxidants, sugar also ages your skin quicker (how can something so yummy do so much damage???).

Cause #4 : MEDICATIONS

Taking long-term medications can disrupt our body’s internal balance and harm our body. When this happens, skin disorders appear to act as a warning signal that something is wrong.

Take for example the use of antibiotics. Now if you really are very sick and having a bad case of infection, then of course it is dangerous not to take prescribed medication. These tend to be only short courses of antibiotics anyway and so do not do as much damage. However, other illnesses may require you to go on a longer course of antibiotics and that’s where it can be damaging to our body. Our body has both good and bad bacteria and is healthy when there is a good balance of the two. Antibiotics do not differentiate between these bacteria, but rather kills both. It can deplete the amount of probiotics, the good bacterial, in your gut and harm the digestive system. Good bacteria helps in food digestion and also the creation of some nutrients, so it not a good thing to be constantly killing the off!

Yes I am aware that dermatologists often prescribe antibiotics for acne as it kills propionibacterium acnes (P. acnes), which is the acne causing bacteria. However I find that this method of treatment is a rather short-term fix as acne sufferers usually have to undergo multiple courses of treatment. Even then, the acne may not disappear forever. It is observed that after multiple course of antibiotics treatment, for those whose acne return, it usually comes back worse or more persistently than before and this is probably due to the damage done to the bacterial balance in our body which can take ages to revert to its optimal levels.

The frequent use of antibiotics also makes us subjective to a whole lot of other health problems such as candida overgrowth. This is actually my next point so I will elaborate there.

Any serious medications (even birth control pills ladies!) that are consumed for a relatively long period can harm our body and the effects usually last for much longer than the period of medication itself. Yes, this also applied to acne medications such as Accutane, which greatly damages our body. I believe that when there is a problem with our internal health, the body generates symptoms to warn us that something is wrong. Acne is just one avenue in which the body is crying out for help.

Cause #5 : CANDIDA OVERGROWTH

Now I just explained that antibiotics kill both bad and good bacteria. Well, the good bacteria are necessary to balance out the amount of yeast (candida) in our body. When healthy bacteria are depleted, this balance is thrown out of whack and an overgrowth of yeast occurs. Those with candida overgrowth can have acne as a result. In fact, there are reports from some people that clearing their candida overgrowth actually cleared their acne!

Cause #6 : INTERNAL HEAT OR DAMPNESS

Eastern medicine believes that acne is caused when there is an excess of heat or dampness (or both) in the body and its organs.

Heat is often associated with inflammation (this occurs in the skin for acne) and can be caused by consumption of too much ‘heaty’ foods such as chocolate, chili, pepper, ginger and fruits like durian or mangoes. I’m not going to write the whole list of heaty foods here, as my post is already longer than I intended and a simple Google search should suffice.

Dampness, on the other hand, is when there is excessive fluid in the body, leading to an environment where bacteria, fungus and viruses can thrive.  This shows up as cysts or pimples with swelling and discharge (pus).  Causes of dampness include weak digestion or gut, taking excessive raw, cold or mucus forming foods (yes, this incudes sashimi, salads, yogurt, milk, cold drinks… … the list goes on), living in damp environments (frequent use of air condition, cold environments), etc.

Cause #7 : COSMETICS

Most cosmetics, even if they claim to be non-comedogenic, can clog pores and lead to acne. Think about it, our skin is an organ that has many functions and one of them is to regulate body temperature through sweat, thus it should be allowed to ‘breathe’. Cosmetics such as foundation and powders coat our skin under a layer of artificial products and throughout the day these products sink into our pores. How can they not contribute to the dirt, dead skin cells, bacteria and sebum already present?

This type of acne, also knows as acne cosmetica, does not happen to everyone. There is no doubt some people can cake their skin in thick makeup day in day out with nary a clog pore in sight. Those of us with more sensitive, oily or simply more clog-prone skin however, should investigate if this is the cause of your acne.

Cosmetic acne can manifest in different forms. Some may experience only clogged pores, and this can be limited to a few areas or be very widespread. Others may get pimples and even cysts from the products.

Even cosmetics with natural ingredients can clog pores and cause acne, even though these products are general less harmful to the skin. Most natural cosmetics consist of a lot of plant oils instead of artificial fillers. However, there are just some people that cannot put oils on their already oily face!

There has been a lot of hype recently around mineral makeup, as the ingredients are made from minerals like zinc oxide, titanium oxide, mica and other coloured pigments. It is touted to be the make up that will clog pores or cause acne, and widely endorsed by dermatologists. Unfortunately, I believe there is no one-product-suits-all as there are some that simply cannot get mineral makeup to work for them. I myself have tried a few and always, always, break out. Just because its mineral and natural does not mean your skin will not react to it. Also, not all mineral makeups are the same and some have ingredients that can actually irritate the skin. One such ingredient that has become quite notorious is bismuth oxychloride.

I would also like to touch a bit on skin care products. Depending on your skin type, products that are not suitable or too harsh can also cause our skin to react in bumps, rashes and acne, so inspect the things you put on your skin! If it works for you, my advise would be - don’t change it!

Cause #8 : LIFESTYLE

The last factor in this post is lifestyle; bad habits that are harmful to your body such as smoking, irregular sleep patterns, unhealthy diet, lack of exercise, stress, and even infrequent bowel movements (okay, gross I know but hey it’s a fact of life, we all gotta do it!) All these affect your health and of course, your hormones so they definitely contribute to acne and its severity. The best is to live a balanced lifestyle with regular sleep patterns, sufficient rest and a healthy diet. Stop putting toxins into your body such as cigarettes and alcohol (or at least do it occasionally if you absolutely cannot totally cut it out). Also, having a happy and positive state of mind is important and does reflect on our skin.

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This list of acne causes is by no means exhaustive of course, but I hope you see how many things affect our skin’s condition. In fact most of these causes are interlinked and are all related to our overall health and wellbeing. Personally, I think my acne was caused by more than half of the above listed factors!

I know the information above may contradict with what your doctors may tell you. I have had some doctors insist that there was no way acne and diet are related. I guess its up to you to decide what to believe.

Do you think your acne is caused by one of the factors listed above? A combination of one or more perhaps? If you have any more possible causes outside of this list, please feel free to let me know in the comments! :)

Lots of Love,

Nicole